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HomeMy WebLinkAbout0188 TIMBER LANE - Health 188. Timber Lade Marstons Mills A= 149—064 i I !I i TOWN OF BARNSTABLv �iGE' Ttf�N O 11rnel- Lh SEWAGE #�t�� 7` S ,yl> l/S ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY �S6d ff>� LEACHING-FACU fTY: (type) �o' (size) NO.OF'BEDROOMS BUILDER OR OWNER PERMITDA IE: COMPLIANCE DATE. Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of leaching Facility Feet Private,Water Supply Well and Leaching Facility (If any wells exist. on site or vAthin 200 feet of!ewhing fwility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet teaching faicility)� Feet Furnished by 6� lk .13 G TOWN OF BARNSTABLE Y LOCATION SEWAGE# 0p0'j-l'74 TILLAGE A9//f ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. J:6. fy SEPTIC TANK CAPACITY If.90 LEACHING FACILITY:(type)—? z4,,.,,A.q (size) 1a. 5 x,?sx a NO. OF BEDROOMS 3 OWNER PERMIT DATE' 7-/-0`I COMPLIANCE DATE: tl Separation Distance Between the: .-Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist q on site or within 200 feet of leaching facility) /OS.S + 1 Sa• Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY s �4y 8 �A - 3 yi' ai %No. Fee � THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Zippricatiou for Oigotar 6paem Cou6tructiou Permit Application for a Permit to Construct( )-��Repair(vy"Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. g M 1 1 en b Pv-)Q Owner's Name,Address,and Tel.No. Assessor's Map/Parcel l L1`1"Z)�oy 1 , I�� M I t� � '�SCJ'1� ga l,), Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. CQ DaLko mills �,1(k d 4 r 27 C Type of Building: Dwelling No.of Bedrooms j Lot Size_,�,ar7 Zsq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min..r--equired) 3 3 O gpd Design flow provided p gpd Plan Date w Number of sheets Z_ Revision Date Title Size of Septic Tank Type of S.A.S. �' ,. -rya Description of Soil �— S Q. NYja t Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by th' B ar of He ,th. Signed Date s OT Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. 0(_r) / Date Issued �_—— =------�--__----_— ——————————— ———————-- 1 No. no Fee VI Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS � f � PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 441 - ZIpprication for Digpofsal *p!5tem Cori.5truction Permit, Application for a Permit to Construct( ) Repair(ye Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. �j M�'jC_'l L,c� Owner's Name,Address,and Tel.No. rn I��S M�,r5{�+S Assessor's Ma /Parcel ! � + r,� C �a11 p 141-D(�k Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. C a341( Its MA �, Z Type of Building: Dwelling No.of Bedrooms Lot Size-2 Z sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) so gpd Design flow provided J��j gpd Plan Date �p D5 Number of sheets Z_ Revision Date Title Size of Septic Tank nn Type of S.A.S. .4 6er __Fen J A ; K Description of Soil 1—.S -Z?A1j VV)e cl( _)&A Se-14 Nature of Repairs or Alterations(Answer when applicable) - i' Date last inspected: < Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of , Compliance has been issued by th' Bar of Hea th. Signed Date Application Approved by Date )5' Application Disapproved b Date y for the following reasons Permit.No! " (22Z �J C� Date Issued -7 l Q THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY that the On-site Sewage Disposal System Constructed ( ) Repaired Upgraded ( ) Abandoned( )by `.J -C at (y M 6I! LT.,e I\A ✓1/1 t S has been constructed in/accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. •,2 0t) 9 ►�(� dr�atted q O Installer = l- >�a 6 Designer L a -Suo #bedrooms '� Approved desi n flow gpd The issuance of thi pe it shall not be construed as a guarantee that the system ilt�1 fu c o as designed. ( �Date f v Cj Inspector /11�1i . n ------- -- -- ------- No. (l� _ --- - - ------ -•--' . Fee THE COMMONWEALTH OF MASSACHUSETTS T PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migofsal *pgtem Construction Permit i Permission is hereby granted to Construct ( ) Repair ( I/f U rade ( ) Abandon ( ) System located at I,2 A ",IA�j 2,iC M M,, S i and as described in the above Application for Disposal lystem Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction usst be completed within three years of the date of this-permit. Date 7 Approved by t y i C � _p Se Pk�jIY/. C e C- w/ / r e 0rt Ylk �Qed CA? C$��' C4114 i 4 No. Fee (�1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 0.��PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Ye ZIppYtcatton for Mt.5pogaY *pqtetn Cowgtructton Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No.%Sf T'.$41pr L n• Owner's me,Address,.N�(/Y illo,�]l A' pl./lf o24Yk Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. S.c. q. /f; cow *-key fo &e 33 7 IW.,-ill-r✓Y!'//f i/v ?No%s A� Rom Type of Building: t"500 -2*-9t ff 50k 6v e 005- Dwelling No.of Bedrooms Lot Size R01 '779 sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) lg;�q 33 d gpd Design flow provided gpd Plan Date Number of sheets evision Date Title Size of Septic Tank Type of S.A S. Description of Soil Nature of Repairs or Alterations(Answer when pplicable) Ser Date last inspected: Agreement: The undersigned agrees to en re the const ction and aintenance of the afore described on-site sewage disposal system in accordance with the provisions of T' le 5 of the E vironmental ode and not to place the system in operation until a Certificate of Compliance has been issued by this ar of Heal h. Sig Date zlo _o? —d 7 Application A proved by Date Application Di pproved by: Date for the following easons Permit No. Date Issued Athat E COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFOn-site Sewage Disposal System Constructed ( ) Repaired (V/) Upgraded ( ) Abandoned( )by_ T C. Ay /21110 at I ka ;.,.,/aH 1"4 has been co tructe cordance with the provisions of Title 5 and sal System Construction Permit No. �' dated Installer Designer n c L #bedro s /, 3r Pe f'm Approved design fl gpd - v The issua his rmit shall not bi const ed as a guara that the system 11 u i n as desi ed. Date Inspector ? ' ; � A . No. * Fee �Iz �/ THE COMMONWEALTH OF MASSACHUSETTS-. Entered in computer: (� PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS Ye/ TippYication for Wgpogar*proem Cowaruction Permit E Application for a Permit to Construct( ) Repair( Ppgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No./O v T'."/P,- Z Owner's �am-e,`A�ddress,and Tel No. " Assessor's Map/Parcel I 141bko �- t Installer's Name,Address,and Tel.No. f Designer's Name,Address and Tel.No. 4�✓�cIVV X,-/fFC 5 t,- C0 Zr. c, PO, r.�Il 3? ,Yl..• >,,�r,�l //s �'l1�✓.7�y� ya ?"�..rr� R���/ Type of Building: /5090%2k-9f 11 r 5�k yo?k oa5-6 Dwelling No.of Bedrooms Lot Size P0,, 779 sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33 gpd Design flow provided gpd Plan_-Date,'Date Number of sheets evision Date w- Title i Size of Septic Tank Type of S.A.S. Description of Soil r r Nature of Repairs or Alterations(Answer when pplicable) Sit e Date last inspected: Agreement: The undersigned agrees to en re.the const ction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of T• le 5 of,the Frxivironmental 1 ode and not to place the system in operation until a Certificate of Compliance has been issued by this ar Hof Heal h. ' r Sig 11 Date /illy _o?"'_a:/ Application Approved by / /�'� Date r r 1 r Application Disspproved by: Date f for the following reasons Permit No. Date IssuedW-6./(_/Y THE COMMONWEALTH OF MASSACHUSETTS . BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that th On-site Sewage Disposal System Constructed ( ) Repaired (L I) Upgraded ( ) Abandoned(s )by J,C, A4 Ito at / !,',,,,�jef, �GN< has been co structe ecordance with the provisions of Title 5 and the osal System Construction Permit No. _ dated Installer R p �l.c�,'u Designer .7 e_ #bedroo s L ,3 -2p r 1oe rm i Approved design fl' gpd o ! The issuan his ptrmit shall not b construed as a guara t that the system w'11 fu ctio n as de! ed. Date Inspector t! J. No. (;x� l./ ' l�"t fJ� - - Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS 1=fgpogar *pgtem Congtruction Permit Permission is hereby granted to Construct ( ) Repair ( �O� grade ( )� Abandon ( ) System located at IkS 7, 1,i-e�,- and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must beitomofeted within three years of the date of thi Date B)qx Approved by __ I Town Of BaTrnstabJe oFY"E r Regulatory Services Y Thomas F. Geiler, Director * MASS. ` Public Health Division y MASS. q iG;g. `gym °'fvrnA+" Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: '7-l4- 09 Sewage Permit#'v� Assessor's Map/Parcel / gslo Installer& Desi2ner.Certification Form Designer: Y/e-wkr--a. C�.o�ac� Su✓�o.� Installer: Address: y0 .L V% Q?N Address: v s rh ��ls� �,q ��rs.�v�,s ,,•l-`/f �1;�oaf�l� 0-a Ll0 On '7— 09 C. / �a- �� was issued a permit to install a (date) - (installer) septic system at 'T 6.er L va Ln based on a design drawn by (address) 1Mu.,, dated S,,> h q Apc n (designer) I certify that the septic system referenced above was installed-substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and th soils were found satisfactory. 5 A S iA,,jh 3 'o r Qj rac►e_ hio VAT/Z-,7w,,,e I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Locales lions. Plan revision or certified as-built by designer to follow. Stripout (if re � rci}? h . .iipected and the soils were found satisfactory. . �� G. s , . !PURPHY N 0.749 (Installer's Signature) AfAi�yg� ALt�_%q (Designer's Sig a ) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice forms\designercertification form.doc TRANS. NO.: CITY/TOWN: APPLICANT: ADDRESS: DESIGN FLOW: u.p gpd REVIEWED BY: DATE: N/A OK NO .� fix: :.,as�.�.�,� ov,�,,,a,L.d&.m �x � A`*��' �_. _ �'�� ,Swriro, fmh m.✓�.-.xs.+ Legal boundaries denoted [310 CMR 15.220(4)(a)] Street, Lot, tax parcel number and lot number noted on plan [310 / CMR 15.220(4)(u)] Locus Provided [310 CMR 15.2204(t)] V Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for components) [310 CMR 15.220(4)] V/v Easements shown [310 CMR 15:220(4)(b)] System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- f not, a variance is required [310 CMR 15.412(4)] Location of impervious surfaces (driveways, parking areas etc.) [310 CMR 15.220(4)(d)] Location all buildings existing and proposed 310 CMR / 15.220(4)(c)] Location and dimensions of system components and reserve areas. [310 CMR 15.220(4)(e)] UP System Calculations [310 CMR 15.220(4)(0] daily flow septic tank capacity(required andprovided) soil absorption system (required and provided) whether system designed for garbage grinder North arrow [310 CMR 15.220(4)(g)) Existing and proposed contours [310 CMR 15.220(4)(g)] Location and log of deep observation holes (existing grade el. on each test) [310 CMR 15.220(4)(h)] Y Names of soil evaluator and BOH representative [310 CMR /a 15.220(4)(h) and (i)] v Location and date of percolation tests (performed at proper / elevation?) [310 CMR 15.220(4)(i)] Percolation test results match loading rate? [310 CMR 15.242] Vv- Certification statement by.Soil Evaluator [310 CMR 15.220(4)0)] •P---� Observed and Adjusted groundwater (method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR Address 1 ! lr if'i. L./�, ►� Sheet l of 7 N/A OK NO Location of every water supply,public and private, [310 CMR 15.220(4)(k)] within 400 feet of the proposed system location in the case J of surface water supplies and gravel packed public water supply within 250 feet of the proposed system location in the case within 150 feet of the proposed system location in the case of private water supply wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins V� located within 50 ft. [310 CMR 15.220(4)(1)] Water lines and other subsurface utilities located [310 CMR 15.220(4)(m)] (if water line cross see 310 CMR 15.211(1)[1]) Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR15.220(4)(o)] Stamp of designer [310 CMR 15.220(1) and 310 CMR 15.220(2)] Stamp of Registered Land Surveyor(required if construction activities within 5 ft. of lot line)[310 CMR 15.220(3)] Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as approved for an grad under LUA at 310 CMR 15.405(1)(k)] Test hole adequate to demonstrate four feet of suitable material? " 1 MR 15.103 4[3 0 C )] Test Holes adequate to confirm adequate groundwater separation? [310 CMR 15.103(3)] Benchmark within 50-75' of system [310 CMk 15.220(4)(q)] Materials specifications noted? [various sections of 310 CMR 15.000] System components not> 36deep (unless ocal U a Approval or LUA requested) [310 CMR 15.405(1(b)] Address Sheet 2 of 7 N/A OK NO � ma ``4- 134 ¢1rm,,.,. � �w�"s''�, :�. ,. � 9 s,� �. t� e Size OK? [310 CMR 15.223(1)] Inlet tee located ten inches below flow line [310 CMR 15.227(6)] Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR 15.227(6)] V 1. Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] Note regarding installation on stable co pacted base [310 CMR 15:228(1)] ��� �C Bhd�'�►� Separation between inlet and outlet tees (no less than liquid depth) [310 CMR 15.227(2)] Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for upgrades under LUA [310 CMR 15.405(1)(k)] Minimum cover 9" (Tanks buried more than 9" must have risers _� on all openings and on the d-box) [310 CMR 15.2228(1) and 310 ► CMR 15.232(3)(f)] Three access covers (inlet and outlet must be 20" or greater)- middle access at least 8" (by 7/07) [310 CMR 15.228(2)] V Access to within 6 " of grade - one port for systems<1 000gpd, two for systems >1000 gpd [310 CMR 15.228(2)] All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] > 10 ft from building foundation [310 CMR 15.211(1)] Buoyancy calculation Required/Done [310 CMR 15.221(8)] H-20 Where appropriate? [310 CMR 15.226(3)] Setbacks from resources [310 CMR 15.211] ualt om a=rtmentTanlc _ wiz . Required when other than single-family dwelling or flow>1000 gpd [310 CMR 15.223(1)(b)] First compartment 200% daily flow; Second compartment 100% daily flow [310 CMR 15.224(2) and(3)] "U" pipe through or over baffle, outlet of each compartment with / gas baffle or approved filter [310 CMR 15.224(4)] Address Sheet 3 of 7 N/A OK NO Located at least ten feet from�any water line? [310 CMR / 15.222(2)] Disposal piping at least 18" below water line (when water and sewer cross, see 310 CMR 15.211(1)[1]) V Cleanouts required/provided ? [310 CMR 15.222(8)] Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable [310 CMR 15.222(6)] Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] V Siphon problem/ (leachfield below pump chamber) Endcaps or vent manifold specified? Size and orientation of discharge holes specified? (not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR 15.252(2)(h)] - Materials specified (310 CMR 15.251(5) specifies various pipe types allowed) �5'�TRIB jl VTIOl $O Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232(2)(a)] Splash plate or baffle tee required on inlet/provided? (when pressure sewer to d-box or steep pitch of gravity sewer) [310 CMR 15.323(3)(a)] Riser if deeper than 9" [310 CMR 15.232(3)(f)] Inside minimum dimension 12" [310 CMR 15.232(2)(b)] Minimum sump 6" [310 CMR15.232(3)(e)] Watertight cover if<2000gpd); waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] V ,��"�. �.� ,�,ri:x. x'z ,'�iz,.s�7).,i�a <ie ,,,...'.���,.,�.., «� <�i ..r�:�s,a" a�` ..� xi�,..'. risa�.'x ...,P �+,•�. Capacity(emergency storage above working=design flow)? [310 CMR 231(2)] Proper setbacks [310 CMR 15.211 (same as septic tanks)] Watertight 20-in minium access manhole at least 20" MUST BE TO GRADE [310 CMR 15.231(5)] Service components accessible (not too deep with piping, / disconnects accessible) V Alarm floats - alarm on circuit separate from pumps specified? Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231(6) and(8)] Stable Compacted Base [310 CMR 15.221(2)] Buoyancy calculations needed ?Provided? [310 CMR 15.221(8)] VOr Address Sheet 4 of 7 z , N/A OK NO S®ILAB502PT 'YEMS�( AS G ��a,"xr,.v, ..%�.,., Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR 15.240(1)] Required separation to groundwater? [310 CMR 15.212)] Aggregate specified as double washed [310 CMR 15.247(2)] System Venting required/provided? (system under driveway or >36" deep) [310 CMR 15.241] Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document] GaESP1RS� OC .:; vsz ,wt� � law Chambers and Gal. in trench configuration supplied with inlet every 20 ft. [310 CMR 15.253(6)] Each structure with one inspection manhole (if>2000 gpd must be to grade) [310 CMR 15.253(2)] Y Aggregate I' minimum.- 4' maximum. [310 CMR 15.253(l)(b)] 2' sidewall credit maximum [310 CMR 15.253(l)(a)] In bed configuration, inlet every 40 sq. ft. [310 CMR 15.253(6)] TAN=GIE31OC� 5�2S1fi �� � tiF � x ,.v �. .._ . �_ Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)] 100 feet- maximum length [310 CMR 15.251(1)(a)] Minimum separation 2x effective depth or width whichever greater(3x if reserve between trenches) [310 CMR 251(1)(d)] V Situated along contours [310 CMR 15.251(2)] Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] �BEbS�AS (NlaXirnumsize o: =ecl�o�fiel_ 500'�' d ., g 4 �� �° minimum 2 distribution lines [310 CMR 15.252(2)(a)] Maximum separation between lines 6' [310 CM R15.252(2)(d)] Maximum separation between lines and outside of bed 4' [310 ✓ CMR 15.252(2)(e)] Aggregate depth below discharge pipes 6 minimum, 12" -/ maximum. [310 CMR 15.252(2)(g)] Separation between beds 10'minimum. [310 CMR 15.252(2)(0] Bottom area used in calculations only [310 CMR 15.252(2)(i)] Address: Sheet 5 of 7 N/A OK NO DIDTkPy� N TNVO � u� Pressure Dosed System ? Provided pump and piping calculations as required [310 CMR 15.220(4)(r)] Pressure dosing required on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and VA Remedial Use Approvals] If used in gravelless system -make sure jet is directed as not to 07 scour soil interface [Guidance Document] Inspections once per year (systems<2000 gpd) or quarterly (>2000gpd) good to note on plan [310 CMR 15.254(2)(d)] - Construction in fill - Did the plan specify that the fill shall meet the specification of 310 CMR 15.255(3)? Impervious barrier and/or retaining wall ? [Guidance Document] Impervious barrier installation must be supervised by designer [310 CMR 15.255(2)(b)] / Retaining wall must be designed by Registered Professional Engineer [310 CMR 15.255(2)(a)] Side slope not exceed 3:1 ? [310 CMR 15.255(2)] Breakout requirements met? [310 CMR 15.252(2) and Guidance Document] At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) [310 CMR 15.255 (2)(e)] g3°' txc�•� �� via a",� ¥-� ..� s�`P` '+YF'� ,, a� 'r ".'<§� ,�s•.� v r.�s�:; GravellessSystem[�/AApp oval�L�etters� J � � . M i s. ' Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil interface Was DEP Approval Letter provided and/or have you / reviewed the letter for conditions? v Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a note on the plan regarding the requirement for perpetual maintenance agreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance J manual? Has applicant submitted a copy of a maintenance NM Are the variances listed on the plan? [310 CMR 15.220 RLS Stamp necessary on plan if a component is within five feet of property line [310 CMR 15.412(4)] 4( New construction or increased flow proposed - [Refer to 310 / CMR 15.414] Address Sheet 6 of 7 N/A OK NO is the system in a Designated Nitrogen Sensitive Area(Zone II for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? [310 CMR 15.214(2)] Are the nitrogen loads proposed in compliance? [310 CMR 15.216(l)] Pumping to septic tank ? [ 310 CMR 15.229] Shared System [310 CMR 15.290] Address Sheet 7 of 7. r©0y TOWN OF BARNSTABLE LOC�.TION j " SEWAGE VILLAGE ��, �1 �-` r ASSESSORS MAP 6t LOT—` INSTALLER'S NAME PHONE NO. rJ SEPTIC TANK CAPACITY I LEACHING FACILITY:(type) �,.�.;,..; r` (size) ��070 NO. OF BEDROOMS RIVATE WEL R PUBLIC WATER --�V BUILDER OR OWNER DATE PERMIT ISSUED: DATE . COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �; e , �JtS7���rTw� �1C 27 (pAb P{2F,•CP6T PfT A f' of��r� Town of Barnstable Barnstable P� ti Regulatory Services Department AI-AmaicaCity uiEuvsrasz,K. 1 1639 Public Health Division m v� :634. � a 200 Main Street, Hyannis MA 02601 2007 Office: 508-8624644 Thomas F.Geiler,Director FAX: 508-790-6304 K Thomas A.McKean,CHO a CERTIFIED MAIL# 70081830000205008567 5/06/2009 American Home Mortgage Servicing Inc. PO Box 631730 Irving, TX 75063 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 188 Timber Lane, Marstons Mills MA was last inspected on April 28, 2009 by Shawn McElroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: Backup of sewage into facility or system component due to an overloaded or clogged SAS. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement actio PER O TH BOARD OF HEALTH Tho` as McKean, R.S., CHO Agent of the Board of Health I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments y 188 Timber Ln Property Address �-�( American Home Mortgage Servicing l�jQ (o3 1 r vl rl -F ` Owner Owner's Name information is Marstons Mills MA required for 02648 4-28-09 — every page. City/Town State Zip Code Date of Inspectio Inspection results must be submitted on this forth.Inspection forms may not be altered in any way. A. General Information 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name 29 Atwater Dr Company Address E. Falmouth MA 02536 City/Town State Zip Code 508-495-0905 S13971 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section.15.340 of Title 5 (310 CMR 15.000).The system: # ❑ Passes ❑ Conditionally Passes ® Fails y ' ❑ Needs Further E aluation by the Local Approving Authority - " CD ¢„ --f c--) 4-28-09 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Appr Bing Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. """This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp official document•03/08 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 1 of 15 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 188 Timber Ln 'M Property Address American Home Mortgage Servicing Owner Owner's Name information is required for Marstons Mills MA 02648 4-28-09 every page., City/Town State Zip Code Date of Inspection B. Certification cont. Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. i Answer yes, no or not determined (Y, N, ND) in the ❑ for the following statements. If"not determined,"please explain. ❑ The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years,o16 is available. s ND Explain: ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed t5insp official document-03108 Trtie 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 188 Timber Ln Property Address American Home Mortgage Servicing Owner Owner's Name information is required for Marstons Mills MA 02648 4-28-09 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced/ ND Explain: l ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed ND Explain: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a mannerwhich will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil:absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 188 Timber Ln 'M Property Address American Home Mortgage Servicing Owner Owner's Name information is required for Marstons Mills MA 02648 4-28-09 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and.the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: I D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: ' Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or Aclogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6"below invert or available volume is less than '/ day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. , t5insp official document•03/08 TrUe 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments l� �M 188 Timber Ln Property Address American Home Mortgage Servicing Owner Owner's Name information is required for Marstons Mills MA 02648 4-28-09 every page. Gity/To`n n State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® T- The system fails. I have determined that one or more of the above failure - - criteria exist as described in 310 CM 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the.system is within 200 feet of a tributary to a surface drinking water supply ❑ 0 the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area — IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 15 Commonwealth of Massachusetts a W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 188 Timber Ln Property Address American Home Mortgage Servicing Owner Owner's Name information is required for Marstons Mills MA 02648 4-28-09 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined? If the were not ® ❑ p Y ( y available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® El approximation in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 188 Timber Ln Property Address American Home Mortgage Servicing Owner Owner's Name information is required.for Marstons Mills MA 02648 4-28-09 every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x #of bedrooms): 330 Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Well Water Sump'pump? ❑ Yes ® No Last date of occupancy: 12-08 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): t5insp official document•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15 Commonwealth of Massachusetts . Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 188 Timber Ln Property Address American Home Mortgage Servicing Owner Owner's Name information is required for Marstons Mills MA 02648 4-28-09 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: - Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 1986 Were sewage odors detected when arriving at the site? ❑ Yes ® No t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 188 Timber Ln Property Address American Home Mortgage Servicing Owner Owner's Name information is required for Marstons Mills MA 02648 4-28-09 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 22 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints,venting, evidence of leakage, etc.): Good condition. Septic Tank(locate on site plan): Depth below grade: 16 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No - - - - - - - - - - - - -------------------------------------------------------------------------------- Dimensions: 1500 Gal Sludge depth: 16" Distance from top of sludge to bottom of outlet tee or baffle 16 Scum thickness 4 5 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? Tape t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 188 Timber Ln �M Property Address American Home Mortgage Servicing Owner Owner's Name information is required for Marstons Mills MA 02648 4-28-09 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank in good condition with baffles installed and no sign of leakage. Recommended pumping for solids. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other (explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 188 Timber Ln Property Address American Home Mortgage Servicing Owner Owner's Name information is Marstons Mills MA 02648 4-28-09 required for State Zip Code Date of Inspection every page. CitYlTown D. System Information (cont.) Tight or Holding Tank (cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): 0 Depth of liquid level above outlet invert Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Box had clear signs of h drolic failure with stains above inlet invert. F Pump Chamber(locate on site plan): Pumps in working order: El Yes ❑ No Alarms in working order: ❑ Yes ❑ No Tdle 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 t5insp official document•03/08 Commonwealth of Massachusetts ' W Title 5 Official 'Inspection Form Subsurface Sewage Disposal System Form =Not for Voluntary Assessments. ^M 188 Timber Ln Property Address American Home Mortgage Servicing Owner Owner's Name information is required for Marstons Mills MA 02648 4-28-09 , every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1-1000 Gal ❑ i leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit had clear signs of hydrolic failure with stains into riser. t5insp official document•03/08 Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 ^ 4 . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 188 Timber Ln Property Address American Home Mortgage Servicing Owner Owner's Name information is required for Marstons Mills MA 02648 4-28-09 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp official document•03/03 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 188 Timber Ln Property Address American Home Mortgage Servicing Owner Owner's Name information is required for Marstons Mills MA 02648 4-28-09 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. r d 0 C Eo= b a5 G r, t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 r <�N Commonwealth of Massachusetts F Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 188 Timber Ln Property Address American Home Mortgage Servicing Owner Owner's Name information is required for Marstons Mills MA 02648 4-28-09 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20' feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers-(attach documentation) ® Accessed USGS database - explain: You must describe how you established the high ground water elevation: USGS maps show groundwater at greater than 20'. t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15 f� J F$s.............. ...�o THE COMMONWEALTH OF MASj5ACHUJ'5'ETTS . BOARD OF HEALTH Appliration for Disposal Morkii Tonitrnr#ion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ............ ....�?M.. v,�M-�P`�y-.._.V` !. ......... ......... ........... •.......' 7..t..4.�.. .•. Location-Address or Lot No. Owner Address a .... ........• �_1�c�.�r.:e.-i ................................ .........�.I... !!�`� -`-`-�.X...--.`' :�:.........----.. Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms..... .................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures -------------------------------------------•---------•--••••-•••--•-••--•••••••..........._.. .._... .._.. W Design Flow..........i 7-6'...................gallons per person per day. Total daily flow...... __ _ gallons. WSeptic Tank—Liquid ca.pacityJ6_dDgallons Length._40....... Width..Z-._-....... Diameter................ Depth................ x Disposal Trench—No..................... Width..........._........ Total,Length.................... Total leaching area....................sq. ft. Seepage Pit No...................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 14 Percolation Test Results Performed bY................................................................••••..... Date......................................... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 04 ................•---------......----------------.....----------..--------...._...--------------------- ------.....------------------ -........ ........Description of Soil................•--•----------------............--------•---.....-•----•---...-------------------------•-------------------------------=------.............._._......... W U Nature of Re airs or Alterations—Answer when applicable_......' � 14 .......1_ .... 1 _.v �'� Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL i , 5 of the State Sanitary Code— The undersigned further agrees o place the system in operation until a Certificate of Compliance has the of heal h. Signed.............. ...... ------ .................. ....................... --•_...9_70�.C1. Application Approved BY ... ......•. •.............. ... --•.-_... ...• --••••••-•._._._.... ---•-•--- �Sf Date Application Disapproved for the f ollowin easons:_..--•-------------------------•-----•---------------------------------...------------..._......._....---....... ........................................................ -•-•.....••--•••-•-•••----......•--•-.....----.._._.....•••••-••-••••-••-.......-----•.....-------••---•- -••••...Da......•-•------- te Permit No..J ...... ......... 9.�M- G Date I �tCl 150 t Fz�s........._.._....._...... ,-± THE COMMONWEALTH OF MASF_4CHU:PETTS BOARD OF HEALTH � r � �-`C)6f Appliration for Disposal Vorkg Tonstrnr#ion rand# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot No. vt. "12F G t Owner Address �/�� ..........................94 ....... _ s ...........1................ pq Installer Address UType of Building Size Lot............................Sq. feet ►-� Dwelling—No. of Bedrooms.......................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) C4 Other fixtures w Design Flow........... ____ __..................gallons per person per day. Total daily flow........ .........................gallons. WSeptic Tank—Liquid ca.pacity)6�:�gallons Length__f 4__.____ Width._ ."....... Diameter.....-_.__�_.___ Depth................ x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-_------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. ; Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................ -.............. Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water_.___.___._.__.__.._.... f4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...........:............ P+ ---•------------------------------••-----------------------••-----.....------••...._.......---------.........................................................O Description of Soil........................................................................................................................................................................ x w U Nature of Repairs or Alterations—Answer when applicable_______11 ........ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 7 1 TiE 5 of the State Sanitary Code —The undersigned further agrees n6f to place the system in operation until a Certificate of Compliance has been issued-b_y he boaffff of health.� Signed-.. _ Application Approved B �� - le� . DPP PP Y t,-r.,. ..tJ.- t Date Application Disapproved for the following-reasons:----•------------------•---••---•---•----...--•-•-------•--••-•-----•-------•---•-----•.._......._............. .........................•---•-------•-------------/•-•-------•-}----------------:..--------...-----.....-----•--------------•----•---------•--------------- ............................................ :? !.� A 1� _� Date Permit No---_.. Issued----•--_-=- l7 ._-_._ ._.. _i--------------••--•---.._.. --Date ................--•--.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 77..-C'I A.,,.l..!�........OF. J..�! C::. .h.. :...........................t 01rrtifiratr of Tontplittnrr THIS IS TO CENT-I-F�, T�at the Individual Sewage Disposal System constructed ( ) or Repaired ......................................................................................................................................... Installer at................... ... -� '` �'' �-A t,-�. � l c -- - �r I_.1... has been installed in accordance with the provisions of TITL: 5 of The State Sanitary Code. as described in the application for Disposal Works Construction Permit No.__ 1 ' 10_______________ dated_------ -? ............. THE ISSUANCE OF THIS CERTIFICATE SHALI,_NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION, SATISFACTORY. � ��.r..A DATE............ 7 !� Inspector....-••---J••••••--•----•-•••---•--•••-------•••--•...........................••. J THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH j ............... 0 r V ..... FEE......... 1 �io�osttl for � �ono#rttr�ion �rrnti# Permission is hereby granted ---�•(.�-- . -• • = ' to Construct ( ) or Repair ( �) an Individual Sewage lDispoosal System at No.........................I-%�••--'-K..-•--- . --,^-.�1,-.' !;:.._�. .�.-:,=----•---`--",� l--+tree-�- ----------- _ !14.�1y�_................................ Street 1 z f as shown on the application for Disposal Works Construction Permit No �•--- ` --_ D��ted.._-__-`...:..... _ _.+_e_a.............. DATE_ / L/ ________________'_________._... Board of llctllh No...........:.•-_._•_.... FEa'........... ................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ------------------.....................-OF.................................................-...................................... _. Appliration for Uigpoiial Workg Toit�trurfiou ramit .Application is hereby made for a Permit to Construct ( ')--or Repair ( ) an Individual Sewage Disposal System at �"./,/g.�.eYr' "•. ,s�� -{ ! /"-to;,.�` e—r ............................................................... ........ w ocatro Address or Lot No. e t ......... .:._ x....... ......•. .........R .............................................. Owner Address a --•................•-..........---•---...--------•...---------...•--•--•---•------•------ .....................41;...-•------•---••-•......-•-•--•---------------._.............•-_.... Installer Address j Q Type of Building Sin Lot.0 _s'�� __Sq. ., U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria 44 Other fixtures ....................................... , w—---------------------------------- --- ----• ---- - -•-•----- Design Flow....._....../ .......................gallons per per-sore per ly. Total daily flow_...... m.. ~� --------•.__gallons: WSeptic Tank—Liquid capacityf��a_gallons Length....=`--------- Width__ '_:?_._ Diameter___.__---------------- Depth--`�=�_'_.._..._.. x Disposal Trench—No----- -------------- Width-.. � ..... Total Length o_�, ,, tal leaching area_._. � sq. ft. Seepage Pit No----L`_-------------- Diameter../.2.-.:.: ..... Depth below inlet_ -.`�.....____. Qtal leaching are L.................s . ft. Z Othen Distribution box ( Dosing tank aPercolation Test Results Performed by �_--------- .......................... ............ Date-&.t- ,-a Test Pit No. 1_ =...: ..minutes per inch Depth of Test Pit f`K� ........ Depth to ground water`........" ...... (i Test Pit No. 2................minutes per inch Depth of Test Pit....................... Depth to ground water........................ w --••••---•- •----- . ;, ............. , D Description of Sotl Lam' -�'* 4l�' ; � � Y ......'ram .,. v�"'• z <...................... ......... •��E•-4f,,i ✓.rtnnjy w-, .r_ L... - •- ................. ......., ....b�----... �_ j _................ .........•_ ___._ W1<p----- ----- --�'-- ------------------- ....... . .... ............•----------- ............................................................... U Natur,� of Repairs or Alterations—Answer when applicable..................... ........................................................................ .............,....----------•--------------•-------•--------------------•----------------------------------...------------.------------......-•-------•---------------------------------------......•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of:T T 17 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compl nce h been is ued by the board of health. �r----------------------------•------------•- Date . ApplicationApproved By.................................................................................................. _.._. Date Application Disapproved for the following reasons.......................................................................... ............................... ` .` u � Date .. 3 Permit No......................................................... Issued_._ `4 ..........=--•----- s 2 Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O&A4T2H. ..........................................OF.................................................................................... Trr$ifiratr of Tompliattrr '° M z ' TH a ha the Ina.vidua Se ge Dispos ysmm const d ( ) r Re •r 11 ) Insta er at--..--•---•-------•------.-•-•.••--•---.---•----------•--------------------•-•--------•--__•-____ . ....................... ... .............- has been installed in accordance with the provisions of T: ` ofhe State Sanitary Code as described in the p Y , application for Disposal Works Construction Permit No......................................... da.ted_............................................... THE ISSUANCE OF THIS CERTIFICATE'SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION S��ACTORY. ` }DATE �d.. -•--------•-....-----•-------•------------ Inspector.... 1 T E COMMONWEALTH, MASSACHUSETTS ....................... O F.............................:....................................................... No.......................... FEE........................ Permis is ranted_....... -- � ._ .t_ ...,.. � " ytt lan'Indid �ra at No j:�<..� .... st as shown on the application for Disposal `'Forks Construction Re it ...... ........ �� ± __--.-_--_._. l odd of Health .DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS s � 1 1 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .......... ....................OF......................................................................................... Allp ira#ion for Bhipogal Workii Toni4rnrtiun ramit Application is hereby made for a Permit to Construct ( '1'-o-r Repair ( ) an Individual Sewage Disposal System at: ......................... ... ......... ............................ ......el..................... /' ���Aer4' or Lot No. LO........................... --��----•-------------------- ..----•--•-----------------------••--•------•- Owner -•...................................•-•---.Address Installer Address Type of Building Size Lot.................7��..Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( � aOther—Type of Building ............................ No. of persons___...__._................_ Showers ( ) — Cafeteria ( ) a Other fixtures . dE-prro� =---------- --------------------------•---...........-------•----•------- W Design Flow.........../ram.......................gallons per pe.seo per�ay. Total daily flow........ . ..................gallons. WSeptic Tank—Liquid*capacit/vim R_gallons Length----.&....... Width..........''.... Diameter................ Depth...r,�.. ...-- x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area.____......_.......sq. ft. Seepage Pit No....l------------- Diameter..loe_S Depth below inlet•(:5>.._... Total leaching area. ��.....sq. ft. z Other Distribution box ( ,.� Dosing tank ( > a ` �� .-- 7 /r 4-120 ~' Percolation Test Results Performed by --..._....v--®-`:.'-..... .............................. Date_ . .__ ........... a ,..a Test Pit No. 1.r.---.;-_2__minutes per inch Depth of Test Pit.�`y_�!�__....... Depth to ground water No"-i........__. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 .....-----••-•...................... --... ........___.4___________ ______ ........__.... � ...._ �..�._._..._.---------._....__.._.... Descriptionof Soil----••-•------•�----�----• --------- ---•-- ..1------ ---.........----Y-------------------------------���---------�- W �� .-f 2 .E' -- ----�"� -'--------------------- ------------------------------. UNature of Repairs or Alterations—Answer when applicable................................. ............................................................... -----------------------------------------------------------------------------------•--•----•------------•----•----------......--------------------------------------•-----------•----••-•••-•........... Agreement: The undersigned agrees to install the aforedescribed Individual-Sewage Disposal System in accordance with the provisions of i ? 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Sigd- ------ - -------------------•......---------------•----------------------...•-- ......._.... ................... D to Application Approved By..._. _ ._._. x_ `- --- 1 1 Date Application Disapproved for the following reasons------------------------------------------------------------------------- ..................................... ...--•---------------•-------•-----•----......-----•--------•---------------------------...---••---•-------•-----•-----------•-•--------•-•-----------------------------•-----•------•--------......... 0-16 Date PermitNo......................................................... Issued--- ��� - ----- Date Town of Barnstable P# i J ,� Department of Regulatory Services s „,MUFAB,,g, : Public Health Division Date /CJ MASS 163 ��� 200 Main Street,Hyannis MA 02601 Date Scheduled LO Time Fee Pd. /(,/0 Soil Suitability Assessment for Sewage Dis osal Performed By. 1-3 -e— I Witnessed By: c`Vr W. n ►\�. LOCATION& GENERAL INFORMATION Location Address J fJ,A I ✓ l� Owner's Name j)w RA-540n5 Address Assessor's Map/Parcel: /L/ g—G Engineer's Name 1/C,n /C r-e 5 ci✓-e" NEW CONSTRUCTION REPAIR Telephone# 503, LI 2 P bn S Land Use i Slopes(%) L- Surface Stones Distances from: Open Water Body L t y ft Possible Wet Area (4�ft Drinking Water Well l© ft Drainage Way ft Property Line t D ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) / �4 J ,✓ ✓ _ lS co �.,.> pp c„ `Parent material(geologic) Depth to Bedrock ? u t ,Depth to Groundwater. Standing Water in Hole: Weeping from Pit FAce - Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: _— __ in. Depth to soil mottles: Depth to weeping from side of obs.hole: _ in, Groundwater Adjustment ft. Index Well# Reading Date: Index Well level , Adi,factor Adj.Groundwater level PERCOLATION TEST Datr Thne..m�, Observation Hole# Time at 9" Depth of Perc Time at 6" Start Pre-soak Time @ _ Time(9"-6") End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed_1 Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1) week prior to beginning. Q:\SEPTICIPERCFORM.DOC DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stricture,Stones,Boulders. Consistency. ravel DEEP OBSERVATION HOLE LOG Hole# - Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,% DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) . (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel t DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Sol] Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. on i ten p•. Flood Insurance Rate Ma . Above 500 year flood boundary_No Yes Within 500 year boundary No= Yes ' Within too year flood boundary No_ Yes , Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system?If not, p y -- what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CNM 15.017. Signature Date Q:\SEpTlCVERCFORM.DOC — • I I I j t i i i : I ! I • , I I I- -T7-_ pu�l e-R I I I I I I • I i ' 1 U ' - � I I , I , I • I -1-�---- _r - -1 -- - -- --- 1 I I 1 I I 1 I I 1 I1 I I I MTI I 1 1 j 1 ' I , i I I i 1 I I t ! I I � j r I , LLJ N + I - -- to-- �-P I----^-i- I-�---i----i--r'-i---- , � . I i I _ -- •--- - - - --- ) -- - ��II pp I T I I j I : , i I i _ 11Iol6er i L.O., -P.1 I , I I Iz _ � I I i I. I I I I i I I i I � j i ' is I 'I• 1 I I I ! i , , , 1 � I i i• � I ; .: I ; I j � I i I � I I I I _ I r� —.. __. __ —Ih- - _I _� - - - - - - - - - -- - '- - -- --- - I ' �vj Jiv ----------- I I , I , , I I ; ; � I j: I , I ' I I I AIIL i F— — i .... I ! • V-L -I___----------- L V, lUtiq- IT-'L ob --------------- ck 1 j I ��j I i i ! I I I -� ' ! � 1 ! ���• I r � I � I r. r I i (Vt I - .......... : �I : : I , � 1 M ; 1 vio �N►1� I I I 1 I p j i I � I I I I I I i ! i I I I �� I �IG�I• � i --- I 1 (� r : r r ---- ` � I 1 I � I I � � i I � .I r I I I I i � j i. I I • I � -- i TP I i y pft : r i i : r I i .. I I I i : ; i y •y{ C) I I I ,it CC AN , CIh ! I 1 , I i , � I I • , _ ; , ' I r I i I i , I , I I I , I I 17 , I I I I I I I I , I • I. I Wof kTIM , o - I , I I ! I --- ---- -----._--f- ------ ---- --- - - - - --- - ---- - - - - - ' I I i I i j I I - - I J I I _ : - -I I . -- (49 -6 q �0 �� s '1 O C A T 10N SEWAGE PERMIT NO. VILLAGE INSTALLER'S { /N+ AME i ADDRESS BUILDER_ OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED O 1 F-LEGENDOVERLAY DISTRICTS: WP, RPOD, ZONE I), MASS ESTUARY Z.O.C. GRAPHIC SCALE WELLS: ® 30 0 15 30 60 ' NOTE: EXISTING GRADES SHALL REMAIN TREES: / UNCHANGED UNLESS OTHERWISE NOTED. PERC TESTS: / � 1 inch = 30 ft. / / TOWN HYDRANT: f,-/ % ® WATER LEACH PIT: EXISTING CONTOURS: — —96 LOT 40 LOT 22 01 0 Fe 108. ft -� LOCUS MAP ` PLAN REF.- 247-82 LOT 41 ` ` "'�„Y, 9Qp' DEED REF 23035-336 20772.2 SQ. FT. ASSESSOR'S MAP.- 149—064 LOT 21 �' „ , ,;;;;;;;;;;;';;;;;;;;� �� / 0.5 ACRES ,,,,,, ,,,,,,,,,,,,,;v:,,,,,, ZONING. »RF,.� , ,;;;;;;;;;;;;;;;; ;;;; SETBACKS- 30 —15 —15 TOWN ,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,, FLOOD ZONE. »O / ,,,,,, ,.v eo�° VENT LOT 13 WATER ,,,,,,,,,#188,,,,, o PANEL NUMBER. 250001 0015 C oQ� DATED. 0811911985 TOWN BM• TOP OF FOUNDATION """"""' "' �"�P ,,,,,.,,,,, sr� c, 7.6ft \ �:�! o WATER ® G� OJT DATUM: ASSIGNED PLOT PLAN OF LAND 6�6 152.9ft`�— !� �� LOCATED AT .._ 0 f f 188 TIMBER LANE MARSTONS MILLS, MA lei TP2 N 0 1 �- % PREPARED FOR.• ,-' PUMP o� TODAY REAL ESTATE �b SHED At. FII_l_ -� ®AAA JUNE 9, 2009 BRUCE 1 LOT 14�. �c'> MUC;PHY ®®�o�a��c S: REV No.749 c LOT 42 a s EPA=ra s �, TOWN �?�,�,z 1 4� DOY�_ REV WELL WATER �~ Al/T A � �, = REV WAFERf�_ ' ®®�9IV YANKEE LAND ,SURVEY .s._ ®® Co., INC. - 6 }r 40 TRY ROAD TOWN iO MARSTONS MILLS, MA 02648 20 WELL TO LEACHING SEPERATION DISTANCE REQUIRED = 150' TM 508-428-0055 FAX 508-420-5553 wo, WATER WELL TO LEACHING SEPERATION DISTANCE DESIGNED = 107.5 SHEET 1 OF 2 JOB # 54512 SH SEWAGE., -SYSTEM PF .0FILE VIEW N . T. S ., T.O.F. EL. 98.5 I' FIN GRADE _ 96.5't , p CD RISERS FIN GRADE 96.2't Y� 20" 2p" tN6 1/8" TO 1/2" DOUBLE WASHED STONE ® 3" THICK OR GEOTEXTILE FABRICDIA. MiNDIA. FIN GRADE 95.5'f �8.5' INSPECTION rINV EL. IR 10" MIN. f 14" MIN. INV EL oRT ON L. 91.86' 393.43' BE OL W FLOW LINE 93.18' INV EV EL.LIQUID LEVEL 48" 91.601.40' EL 91.03' ° o 0 v GAS BAFFLE 6 STONE pIs RIBUTION BOX ° ° _ _v_ _ _ _m_ _ ° ° EL 89.03' \jvs,u�' EXISTING 1500 GALLON TANK ° 4,9 ° 3/4" - 1 1/2" °4.8"° k � PRECAST REINFORCED CONCRETE DISTRIBUTION BOX DOUBLE WASHED STONE TEES SHALL BE CONSTRUCTED OF SCHEDULE 40 PVC AND SHALL EXTEND A DISTRIBUTION BOX SHALL HAVE WATERTIGHT COVER 25' d MINIMUM OF 6" ABOVE THE FLOW LINE OF THE SEPTIC TANK AND BE ON MINIMUM WALL THICKNESS = 2" CV THE CENTERLINE OF THE SEPTIC TANK LOCATED DIRECTLEY UNDER THE MINIMUM INSIDE DIMENSION 12" PROPOSED CHAMBER TRENCH cj J Sys" S CLEAN-OUT MANHOLE. OUTLET INVERTS SHALL BE EQUAL TO EACH OTHER AND AT J THE INLET PIPE ELEVATION SHALL BE NO LESS THAN 2" NOR MORE THAN 3" 2" MINIMUM BELOW INLET INVERT. ABOVE THE INVERT ELEVATION OF THE OUTLET PIPE. THE DISTRIBUTION LINES FROM THE DISTRIBUTION BOX SHALL ALL HAVE i�s N Q SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9" EQUAL INVERTS AS DETERMINED BY FLOODING THE DISTRIBUTION BOX TO PERFORM 5' STRIPOUT DO:WNTO C2 HORIZON 1. THE HEIGHT OF THE DISTRIBUTION LINE INVERT AFTER ALL LINES HAVE (APPROX. ELEV. 88.8'). L CONDITIONS BOTTOM OF SOIL PIT = EL. 79.8' TWO 20" MANHOLES WITH READILY REMOVABLE IMPERMEABLE COVERS BEEN SEALED IN PLACE. SHALL BE INSPECTED PRIOR SOIL REPLACEMENT NO GROUND WATER OR OF DURABLE MATERIAL SHALL BE PROVIDED WITH ACCESS PORTS. INVERT ADJUSTMENTS SHALL BE MADE BY FILLING WITH DURABLE AND PER TITLE V RETIONS. REDOXIMORPHIC FEATURES OBSERVED MIDDLE ACCESS PORT SHALL BE 8" DIA. MINIMUM. NONDEFORMABLE MATERIAL PERMANENTLY FASTENED TO THE LINE OR THE OUTLET TEE SHALL BE EQUIPPED WITH GAS BAFFLE. RECONSTRUCTING THE LINES UNTIL ALL INVERTS ARE OF EQUAL ELEVATION. DISTRIBUTION BOX SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL, STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON WHICH 6" OF CRUSHED STONE HAS BEEN PLACED TO ENSURE STABILITY AND TO PREVENT SETTLING. 4" PVC SEPTIC TANK CAPATICY: VENT REQUIRED — 330 GALLONS AT 200% DESIGN DATA: PROVIDED — 1500 GALLONS TO REMAIN THREE BEDROOM = 3 X 110 = 330 GPD REQUIRED FLOW FIN GRADE = 95.5't NO GARBAGE DISPOSAL ALLOWED 12.83' USE: CHAMBER TRENCH 251 X 12.83'W DEPTH 34" ° �° ° ° °° ° °• °� (25' + 25' + 12.83 + 12.83) X 2.0 151 S.F. ° °� ° • ° � °` 24" GENERAL NOTES: � 1 . ALL THE WORKMANSHIP AND MATERIALS SHALL CONFORM TO DEP 25' X 12.83 320 S: 48" ° 58" ° 48" TITLE V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS 471 X 0.74 = 348 GPD TOTAL DESIGN FLOW FOR THE SUBSURFACE DISPOSAL OF SEWAGE. NUMBER OF TRENCHES = ONE 2. ACCESS PORTS OVER TANK TEES SHALL BE ACCESSIBLE WITHIN 6" NUMBER OF UNITS = OF FINISHED GRADE PROPOSED LE TRENCH — END VIEW 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF ' wsrALL 500 GALLON UNITS WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10' WITH FOUR FEET OF DOUBLE WASHED STONE OF DRIVES OR PARKING. H-20 LOADING SHALL BE USED UNDER OR WITHIN AT SIDES AND ENDS 10' OF DRIVES OR PARKING, UNLESS NOTED. T.P. #1 PER C <2 M/INCH T.P. #2 PERC <2 M/INCH 4. THE EXCAVATOR/CONTRACTOR SHALL CALL "DIG SAFE" AND VERIFY THE LOCATION EL. 95.8' o» EL. 95.8' o„ (r OF SITE UTILITIES PRIOR TO ANY EXCAVATION, AND SHALL BE RESPONSIBLE FOR 10 YR 3/2 10 YR 3/2 ALL MATTERSRELATING TO ELECTRIC AND/OR GAS EASEMENTS. AE" "SL" 6„ AE "SL" 6„ 5. SEWER PIPES SHALL BE SCHEDULE 40 PVC. (4" DIA. UNLESS UTHERWISE NOTED) „B„ "L.S" 10 YR 4/6 „B„ "LS„ 10 YR 4/6 6. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE 24" 24" SOIL DATA: MORTARED IN PLACE AND SECURED TO UNAUTHORIZED ACCESS. TIGHT 10 YR 5/6 TIGHT 10 YR 5/6 TEST DATE: 06- 1 1 -2009 C LS11 "C 1 LS 7. FINISH GRADE SHALL 1 HAVE A MINIMUM SLOPE OF 0.02 FT. PER FOOT. 84 (EL. 88.8') 84 EL. 88.8' , r SOIL EVALUATOR. BRUCE MR.S. 8. EXISTING SYSTEM COMPONENTS IF ANY SHALL BE ABANDONED PER URPHY R.S MEDIUM MEDIUM APPROVAL DATE: ________ TITLE 5 REQUIREMENTS. (PUMP AND FILL LEACH PIT.) "C2" SAND 10 YR 7/4 "C2" SAND 10 YR 7/4 9. THE EXCAVATOR/CONTRACTOR SHALL BE RESPONSIBLE TO CONTACT YANKEE 3 HEALTH AGENT: DAVID STANTON SURVEY 24 HOURS PRIOR TO ANY REQUIRED INSPECTIONS. EL 79 8 192" EL 79.8 192" P# 12,592 10. ALL COMPONENTS SHALL BE MARKED WITH MAGNETIC TAPE OR NO G\WATER OR NO G\WATER OR COMPARABLE MEANS IN ORDER TO LOCATE THEM ONCE BURIED. REDOXIMORPHIC FEATURES REDOXIMORPHIC FEATURES SHEET 2 OF 2 JOB NUMBER__ 54512 1 L -7-4>p o f fou�o� _ 74 � e% = 72.00 „O„ bob • 72 70 — — — — — — — o — _ �XGaVc�fe a/l jm�erVio�� rr�aferia% frorrl 68 -- - w.: �'X� /eac�r P;� withir7 /o ' rcLd;u� of /eo"cb pif ct,r7al rep/ace Co90o y; 68.z6 W ` /ir7ed -, (,��a ' of Wif'�j G�ear7 tneolivrt'7 SOLri,o� 64 G795 wexz ed 8 sf ane. G 43 ,�. �z G8.75 Wig.50 60 bot,�o�, /each 58 _ pi, 54 _ O /V /D ---- - - --o -- o --o --o - - proPoseo� 9rouno/ vr~of' e HOi21Z. SCALD: / _ /O (/ E � T SCf� LE /' _ � i washes/ stone G r 70-0 T t' 7/jam x- ® .5 T B D X --+-- "0(,a • 6' Sump J ' I /000 GAt- SEPT/G TAA/k f - / r , 3.63 — SIG S / G A, 28 O z y O -- — - d Y. S oQ � M T-�� TE sT ASY ` JoAJC 1/ r7c .e T l a. ef" o e- 0 ZAJ ea ! 77 ,3 5.f. �o O�'ru1"7 1-7 5 4. PT/ L TA/V S = a C9°9 47 USE : T,9ti/K TEST /-7iOL E # / TEST HOLE # Z LE-�iGH /O. 5 - /Darn , \ EFL OEPTf/ w.0� 5 L�So / \ \ 24 e l / 5/OE[.Vi4LL S.F <2. 5 ) = 494 $GAGS/pAY t/9i77e�d(iurr7 BOT TOM 5ar7d / /O, _ TOT,9L SS/•-�_ Gr9 � S. �OAY , f 9�-ave / � N !p USE /- GEAGf! �/T � el G4.9 1 77ed,ur -1 1 - Q 4 / C 0 6L e. Hof /4 r7 0 w�, {e r-- e r-n C 0 L)r-17�g r e T� �/ P,�OPOSEG� OAJ Tf-1& f AeOUNL) /q S f �' SHOIiVtiJ ON T,' !/S GOA/F0A--1L-7 TO THE BC 14- L7V JG SET- BAGJ� � � QU/ EEMENTS OF THE � 7-O 4oV A.1 O F SETBAG ,E' E- QU/,EE /NIE A/TS i BYYFgi ,- _ ScAt fIS S </ 0LAJAJ OATS . - - - - S ZA//q G E- s �'-S 7-- 1 s 7- ro E titi/,S SG G E : / „- mac , - - - - - - -- G7�, St, nc? C0t-7- o- s 4B0 ,q,2c7 OF //Ef,'LTH —o —o -- o—o --- propose Gon Ou/'s � � �.� / f?� 11/�ASS 7�_ / -- ---- - ---- - - -- --